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A true physician does not downplay the pain that their work causes and has caused like Dr. Felix does in his presentations. Too many surgeons seem to be so focused on spreading the neat new techniques and technologies that they are willfully ignoring the fact that mesh is over-used and has real problems associated with its use. There is no study out there that has suggested that improper mesh placement is the cause of chronic pain. To the contrary, efforts to find the cause besides the mesh itself have all failed. And, also contrary to the the recurrence myth that is being spread, recent studies are showing that laparoscopic mesh placement has a significantly higher recurrence rate than what is being propagated. I posted a paper about it recently, I will relink it below.
It would be great if somebody could truly show a clear path to reducing the risk of chronic pain and recurrence. But people like Dr. Felix are out there suggesting that patients who complain of pain and discomfort are just weak, as he does in his “Let’s be honest…” presentation. To paraphrase Dr. Felix – “let’s be honest, mesh is not the great panacea that it is being promoted as”. It just isn’t.
The mesh makers are still selling the products that the Guidelines recommend against. The Guidelines “update” seems to be delayed for some reason, even though professionals in the field have published papers to help create better Guidelines.
I am sure that you are aware that nothing of significance at all has happened in the five years since the Guidelines have been published, except advancements in ways to get more mesh in to more patients. And besides Atrium getting sued for their fish-oil coated mesh, and Bard getting sued for their polypropylene mesh plugs. Chronic pain was identified as the number one problem in the hernia repair field just a few short years ago. Right about the time that Dr. Felix started his 10 Commandments tour. Chronic pain and mesh removal is now normalized as part of mesh implantation, with new pain center businesses created to handle the new business. It’s insane.
https://herniatalk.com/forums/topic/the-state-of-teaching-hernia-repair-dr-felix/